Influence of decision aids on patient preferences for anticoagulant therapy: a randomized trial
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TLDR
The decision aid led to significant improvement in patients' knowledge regardless of the format or graphic representation of data, and Revealing the name of the treatment options led tosignificant shifts in declared treatment preferences.Abstract:
Background: Decision aids have been shown to be useful in selected situations to assist patients in making treatment decisions. Important features such as the format of decision aids and their graphic presentation of data on benefits and harms of treatment options have not been well studied. Methods: In a randomized trial with a 3 × 2 factorial design, we investigated the effects of decision aid format (decision board, decision booklet with audiotape, or interactive computer program) and graphic presentation of data (pie graph or pictogram) on patients9 comprehension and choices of 3 treatments for anticoagulation, identified initially as “treatment A” (warfarin), “treatment B” (acetylsalicylic acid) and “treatment C” (no treatment). Patients aged 65 years or older without known atrial fibrillation and not currently taking warfarin were included. The effect of blinding to the treatment name was tested in a before–after comparison. The primary outcome was change in comprehension score, as assessed by the Atrial Fibrillation Information Questionnaire. Secondary outcomes were treatment choice, level of satisfaction with the decision aid, and decisional conflict. Results: Of 102 eligible patients, 98 completed the study. Comprehension scores (maximum score 10) increased by an absolute mean of 3.1 ( p p Interpretation: The decision aid led to significant improvement in patients9 knowledge regardless of the format or graphic representation of data. Revealing the name of the treatment options led to significant shifts in declared treatment preferences.read more
Citations
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The management of non-valvular atrial fibrillation (NVAF) in Australian general practice: bridging the evidence-practice gap. A national, representative postal survey
TL;DR: GPs themselves have provided guidance on the selection of implementation strategies to bridge gaps in the current care of NVAF, and these results may inform future initiatives designed to reduce the risk of fatal and disabling stroke in NVAF.
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Patient values and preferences for antithrombotic therapy in atrial fibrillation. A Narrative Systematic Review.
TL;DR: This paper performed a narrative systematic review to provide clinicians with insights into the values and preferences of atrial fibrillation (SPAF) patients for SPAF antithrombotic therapy.
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Patients' experiences of atrial fibrillation and non-vitamin K antagonist oral anticoagulants (NOACs), and their educational needs: A qualitative study
TL;DR: The need for patient involvement in the development of educational materials and resources for patients commencing treatment with NOACs is highlighted, and patient recommendations emphasised the need for interventions to relieve anxiety surrounding the diagnosis and possible treatment side effects.
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Availability of patient decision aids for stroke prevention in atrial fibrillation: A systematic review.
Elizabeth S. O'Neill,Stuart W. Grande,Ariel Sherman,Glyn Elwyn,Megan Coylewright,Megan Coylewright +5 more
TL;DR: Using decision aids for stroke prevention in atrial fibrillation was associated with increased patient knowledge, increased likelihood of making a choice, and low decisional conflict; use of decision aids in this review wasassociated with less selection of warfarin.
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The effects of decision aid structural restrictiveness on decision-making outcomes☆
TL;DR: In this paper, the authors investigate whether restricting how users interact with computerized decision aids affects their performance by limiting their ability to consider other possible problems that may not be prompted by the decision aid.
References
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“Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician
Marshal F. Folstein,Marshal F. Folstein,Susan E B Folstein,Susan E B Folstein,Paul R. McHugh,Paul R. McHugh +5 more
TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
A practical method for grading the cognitive state of patients for the clinician
TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
Journal ArticleDOI
The outcome of childhood Haemophilus influenzae meningitis. A population based study.
TL;DR: To determine the morbidity and mortality from childhood Haemophilus influenzae type b (Hib) meningitis in a well defined population, a large number of cases are diagnosed with Hib.
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Placebo-controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. The Copenhagen AFASAK study.
TL;DR: The incidence of thromboembolic complications and vascular mortality were significantly lower in the warfarin group than in the aspirin and placebo groups, which did not differ significantly.
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Stroke Prevention in Atrial Fibrillation Study. Final results.
TL;DR: Aspirin and warfarin are both effective in reducing ischemic stroke and systemic embolism in patients with atrial fibrillation and patients with nonrheumatic atrialfibrillation who can safely take either aspirin or warfarIn should receive prophylactic antithrombotic therapy to reduce the risk of stroke.